Individual provider Active NPI

Traci C Jamieson, LPC

  • Professional Counselor
  • McCall, ID
National Provider Identifier
1508457458
Registry record updated Feb 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
8007 Issued in ID
Practice address
125 Commerce St
McCall, ID 83638-5192
Phone
(208) 634-2962
Fax
(208) 634-5064
NPI assigned
Feb 2, 2021
Last updated
Feb 2, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 2, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X 8007 ID Primary

Addresses

Primary practice location

125 Commerce St
McCall, ID 83638-5192

Mailing address

PO Box 768
McCall, ID 83638-0768
Phone (208) 630-4200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
8007IDMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Ignite Idaho Family Resource Center Inc Counselor Current Accepting new patients
Jamieson Consulting Professional CurrentSince Apr 17, 2022 Accepting new patients

Locations

106 E Park St
Ste 218
McCall, ID 83638
Phone (208) 630-4200

106 E Park St
Ste 220
McCall, ID 83638
Phone (208) 994-5537

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1612224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612224000000",
    "number": "1508457458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 768",
            "city": "MCCALL",
            "state": "ID",
            "postal_code": "836380768",
            "telephone_number": "208-630-4200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 COMMERCE ST",
            "city": "MCCALL",
            "state": "ID",
            "postal_code": "836385192",
            "telephone_number": "208-634-2962",
            "fax_number": "208-634-5064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAMIESON",
        "first_name": "TRACI",
        "middle_name": "C",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-02-02",
        "last_updated": "2021-02-02",
        "certification_date": "2021-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "ID",
            "license": "8007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McCall, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.